武汉市2012-2015年发热呼吸道症候群监测病例病毒检测结果分析

Analysis on the detection results of case surveillance of febrile respiratory syndrome in Wuhan City from 2012 to 2015

目的了解武汉地区发热呼吸道症候群的病原谱分布和流行特征,为防控及临床诊疗提供科学依据。方法用实时荧光聚合酶链式反应法,对2012年3月~2015年2月间收集的576份呼吸道感染病例咽拭子标本进行病毒核酸检测。结果 576份标本中,检出阳性标本248例,阳性检出率为43.1%。男、女病例标本阳性检出率差异无统计学意义(x^2=0.371,P=0.542)。阳性标本中,单一病毒所致感染208例,混合感染40例,病原谱构成以腺病毒、鼻病毒和甲型流感病毒为主,占比分别为19.4%、17.3%和14.1%。呼吸道合胞病毒B型、腺病毒、博卡病毒和混合感染在各年龄段差异有统计学意义(均有P<0.05),腺病毒、混合感染以2~岁人群为主,博卡病毒只在2岁以下人群中有发现。各病毒流行季节不同,具有季节差异性(x^2=17.427,P=0.001),春季检出率最低。结论腺病毒、鼻病毒和甲型流感病毒是武汉地区发热呼吸道症候群的主要病原体,<5岁为主要易感人群。不同流行季节病毒谱也不一致,加强对上述病毒的监测和研究,应作为本辖区呼吸道病毒的防控重点。

Objective To analyze the viral pathogenic spectrum and epidemiological characteristics of febrile respiratory syndrome（ FRS） in Wuhan City,so as to provide theoretical basis for prevention,control and clinical diagnosis and therapy of FRS. Methods The swabs specimens from 576 patients of FRS were collected from Mar 2012 to Feb 2015,and detected by using real-time fluorescent quantitative polymerase chain reaction（ PCR）. Results A total of 576 specimens were tested,248 specimens were positive for viral ncleic acid,and the positive rate was 43. 1%. No statistically significant difference was found in the positive detection rate between males and females（ x^2= 0. 371,P=0. 542）. Among the248 positive specimens,208 indicated for single infection and 40 indicated for mix infections. Among the detected respiratory viruses,adenovirus（AdV）,rhinovirus（ HRV） and influenza A virus（ FluA） accounted for the large proportion profile,the rates were 19. 4%,17. 3% and 14. 1%,respectively. In different age groups,statistically significant differences were found in the infection rates of respiratory syncytial virus B,Ad V,Bocavirus（ Bo V） and co-infection（ all P〈0. 05）,the age group of 2-was significantly different from others in the Ad V infection and co-infection and the Bo V infection was found only in the age group of 2. The different respriratory viruses were prevalent in different epidemic seasons. The detection rates of virus were significantly different in different seasons（ x^2= 17. 427,P=0.001）,the detection rate of virus was the lowest in the Spring. Conclusions Ad V,HRV and Flu A were important pathogens of FRS in Wuhan City,children under age of 5 were high risk population. The composition of pathogenic spectrum was different in different seasons,it was necessary to conduct further surveillance and more in-depth investigation targeted on prevention and control of the febrile respiratory illness caused by these respiratory viruses.